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桡腕掌关节形态参数与关节接触压力的关系:骨关节炎发展的一个可能因素。

Relationship between trapeziometacarpal joint morphological parameters and joint contact pressure: a possible factor of osteoarthritis development.

机构信息

Aix-Marseille University, CNRS, ISM, Marseille, France; Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France.

Aix-Marseille University, CNRS, ISM, Marseille, France.

出版信息

J Biomech. 2023 May;152:111573. doi: 10.1016/j.jbiomech.2023.111573. Epub 2023 Apr 5.

Abstract

The trapeziometacarpal (TMC) joint is the one of the hand joints that is most affected by osteoarthritis (OA). The objective of this study was to determine if specific morphological parameters could be related to the amount of pressure endured by the joint which is one of the factors contributing to the development of this pathology. We developed 15 individualized 3D computer aided design (CAD) models of the TMC joint, each generated from the CT scan of a different participant. For each participant, we measured several crucial morphological parameters: the width and length of the trapezium bone and dorso-volar and ulno-radial curvature, of the trapezium and the metacarpal bone. Each CAD model was converted into a finite element model, of both bones and the cartilage located in between. The joint forces applied during pinch grip and power grip tasks were then applied in order to estimate the contact pressures on joint cartilage for each model. Correlations between joint contact pressures and morphology of the trapezium and the metacarpal bone were then analysed. Important variations of TMC joint pressures were observed. For both pinch and power grip tasks, the strongest correlation with joint contact pressure was with the dorso-volar curvature of the trapezium bone. Our findings indicate that dorso-volar curvature of the trapezium bone has a significant impact on mechanical loadings on the TMC joint. This contributes to understanding the prevalence of OA in certain patients.

摘要

腕掌(TMC)关节是手部关节中最易受骨关节炎(OA)影响的关节之一。本研究旨在确定特定的形态参数是否与关节承受的压力有关,而关节承受的压力是导致这种病理发生的因素之一。我们为每个参与者的 CT 扫描分别生成了 15 个 TMC 关节的个体化三维计算机辅助设计(CAD)模型。对于每个参与者,我们测量了几个关键的形态参数:手舟骨的宽度和长度,以及舟骨和掌骨的背侧-掌侧和尺桡侧曲率。然后,将每个 CAD 模型转换为骨骼和位于两者之间的软骨的有限元模型。然后施加捏夹和紧握任务时的关节力,以估算每个模型的关节软骨的接触压力。然后分析了关节接触压力与舟骨和掌骨形态之间的相关性。观察到 TMC 关节压力的重要变化。对于捏夹和紧握任务,与关节接触压力相关性最强的是舟骨的背侧-掌侧曲率。我们的研究结果表明,舟骨的背侧-掌侧曲率对 TMC 关节的机械载荷有显著影响。这有助于了解某些患者中 OA 的流行情况。

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